Cadaver Graft in Rhinoplasty, are there any complication using this kind of graft?

Question

I'm considering a primary rhino/septoplasty and have very thin skin. The option of using cadaver tissue, I believe the product might have been Alloderm, was given as an option by a surgeon I consulted with. Are there any complications using this kind of graft and would using one cause my nose to be more swollen or look bulkier as a result? Thank you for your input

Jacob Sedgh, MD · Answer

Alloderm has been used in rhinoplasty for a long time now with durable results and track record. However, there is always speculations about using cadaveric tissue versus own tissue in the surgical world. The alternative is temporalis fascia graft which can be taken via a small incision on the scalp. There is a fine balance as far as thickness of the skin on the upper portion of the nose. If too thin , the skin can show even subtle imperfections easily, on the other hand, if too think, the skin may look unnatural.

Christopher Kolstad, MD · Answer

Very thin skin can shrink wrap too much revealing subtle imperfections that would otherwise be camouflaged by thicker soft tissue.  Thin skin may benefit from a tissue thickener, similar to carpet padding underneath the carpet.  If you are concerned about cadaveric tissue using temporalis fascia may be something to discuss with your surgeon.

John Layke, DO, FACS · Answer

Acellular Dermal Matrices (ADMs) like Alloderm are often used as substitutes to camouflage contour irregularities if a patient's tissue is not readily available.  Complications, although rarer, include redness, swelling, infection, bulkiness, and additional contour irregularities.  It may be helpful for you to provide photos so that we may offer the appropriate advice.

Thomas Hubbard, MD, FACS · Answer

With Septorhinoplasty and the plans your surgeon thinking appropriately what could be proactive with very thin skin.  Alloderm is a choice but I find a persons own tissue less likely to cause problems.  Your own temporalis facia, which is a thin tissue over one of the chillian muscles in the temple, is easily harvested and does very well for a nice little bit of carpet padding like tissue beneath the skin.

William Portuese, MD · Answer

In our practice, we prefer to use patient's own tissues rather than cadaveric tissues. A thorough examination of the nose will be required to see what is required during the rhinoplasty procedure, and how thin the skin is over the bridge of the nose. Choose your rhinoplasty surgeon wisely based on extensive experience producing natural results

Remus Repta, MD · Answer

Great question.  You have several options to address the "thin skin".  First, if the cartilage contour is smooth thin skin or thin soft tissue will not be a problem since no irregularities will be seen.  If the thickness of the soft tissue (skin and underlying fat) needs to be thickened for whatever reason, you have three main options:-cadaver skin-your own tissue (fascia or skin)-fatI have used all three and all three can be a good choice.  I have found that this is rarely needed in primary rhinoplasty unless its used to wrap diced cartilage for things like nose bridge elevation.  If you end up using your own tissue, fascia from your temple or a de-epithelialized piece of skin from your lower abdomen work well.  Fat transfer needs to be done prior to or after the rhinoplasty procedure to allow the fat to take hold.All the best,Dr. Remus Repta

Richard W. Fleming, MD (retired) · Answer

Although cadaver grafts oe synthetic material such as Alloderm can be used to augment the nose I prefer to use the patient's own cartilage , usually harvested from the septum or ear, because survival of the graft and incorporation within the normal surrounding tissue is better.

Cadaver Graft in Rhinoplasty, are there any complication using this kind of graft?

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